DOCTORS were left stunned by the mysterious case of a boy who began to spontaneously cry tears of blood.
Over a period of six weeks, the rivulets of blood leaking out of his eyes grew thicker and more frequent – often exacerbated by going to the loo.
BMJ GroupA boy in his mid teens began spontaneously crying tears of blood[/caption]
BMJ GroupThe picture shows the patient during an episode of active bleeding[/caption]
BMJ GroupInitial tests showed no abnormalities, but the teen came back a month later steadily increasing bleeding from his right eye[/caption]
The “alarming” case was detailed in paper published to BMJ Case Reports.
The boy in his early teens first visited eye specialists in Bangalore India, after blood began oozing his right eye and right nostril two weeks prior.
The bloody tears were “painless” but “progressively increasing”, doctors noted in their report.
“There was no history of recent trauma, bleeding from any other mucosal surfaces or psychiatric illness,” they added.
Initial tests revealed no notable abnormalities.
The boy had 20/20 vision, his tear drainage system was free flowing with no evidence of haemorrhages, nor were there issues with his sinuses.
But the boy returned a month later with increasing bleeding from his right eye.
Curiously, his condition seemed to be “aggravated” by peeing.
The teen’s eye wasn’t actively leaking blood during his second examination, but medics noted that his lower eyelid showed evidence of “maceration” – when skin is broken down due to repeated exposure to moisture – and bleeding.
“The patient was asked to pass urine and frank bleeding was noted from the right eye,” doctors said.
Upon further examination, it was revealed that the teen had “malformed blood vessels consistent with a vascular malformation”.
After referring him to a neuroradiologist for further tests, the boy was diagnosed with “conjunctival micro arteriovenous malformation”.
Arteriovenous malformations (AVMs) happen when a group of blood vessels in your body forms incorrectly, according to Johns Hopkins Medicine.
In these malformations, arteries and veins form an abnormal tangle, which usually happens during development before birth or shortly after.
These tangles can form in the brain or anywhere else in the body like the face, arms or legs, and in tissues and organs like your heart, liver or lungs, according to Cleveland Clinic.
In the boy’s case, an AVM was found in his inferior forniceal conjunctiva – the lower eyelid.
People who have malformations in their veins and arteries often won’t experience problems.
But there is a risk of bleeding due to the vessels rupturing.
“This is the first reported case of haemolacria due to an underlying conjunctival micro arteriovenous malformation,” doctors noted in their report.
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Other cases of ‘bloody tears’ have been caused by inflammatory conditions, trauma or use of blood thinning medications.
It was decided that the boy would undergo endovascular embolisation – a procedure that fills or closes blood vessels to prevent bleeding or rupturing.
Surgeons were able to successfully treat his condition, and the boy only experienced mild pain and swelling to his eyelid following his operation.
When medics checked in two weeks post-op, the boy had experienced no more bloody tear episodes and there was only some minor scarring at the site of the procedure.
“He continues to remain asymptomatic at six-month follow-up,” they noted in their report.
“Haemolacria, characterised by spontaneous bleeding from the
ocular surface, is a rare condition,” they wrote.
“The degree of haemorrhage can range from sanguineous watery discharge to frank bleeding with a variety of causes previously reported.”
Previously, 22-year-old man in India who went to hospital after crying tears of blood left doctors stumped, as they were unable to figure out the cause.
BMJ GroupDoctors found that his bleeding episodes were aggravated by peeing[/caption]
BMJ GroupThey found that an arteriovenous malformation was the cause of his bleeding[/caption]
Surgeons were able to correct the malformation and the boy had reported no new episodes six months post op